Recent Data on Irritable Bowel Syndrome from some Central and East European Countries.

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Efficacy of budesonide in collagenous colitis Evaluation of: Miehlke S, Madisch A, Kupcinskas L, et al. Budesonide is more effective than mesalamine or placebo in short-term treatment of collagenous colitis. Gastroenterology 2014;146(5):1222-1230 e1222.

INTRODUCTION: Collagenous colitis (CC) is a less common colonic disease with variable prevalence and undulating course. Among the available therapies, budesonide was demonstrated to induce a rapid and sustained remission in many cases, but little is known about the comparative efficacy of other treatments, such as mesalamine. AREAS COVERED: Evaluation of a randomized study assessing the efficacy and safety of budesonide over mesalamine in patients with CC. EXPERT OPINION: Data from the study showed that budesonide was significantly superior to placebo and to mesalamine and further supports the recommendation of the current guidelines on the use of budesonide in CC. However, other forms of mesalamine may further be evaluated for this disease.

Diet and irritable bowel syndrome.

BACKGROUND AND AIMS: Recent papers highlight the role of the diet in irritable bowel syndrome (IBS), but very few population-based studies have evaluated this. The aim of the study was to determine the prevalence of IBS in the general urban population and to evaluate the type of diet associated with IBS symptoms. METHODS: A randomized sample of subjects (n=300) from a general urban population in Romania selected from family doctors' patient lists was invited for interview in the doctor's office. Selected subjects were evaluated for the diagnosis of IBS using Rome III criteria and for their eating habits and diet using a food frequency questionnaire. Socio-demographic factors and general medical history were also included in the interview together with standard weight measurements. Results from logistic regression were presented as odd ratios and 95 % confidence intervals. RESULTS: From the selected sample, 193 subjects (80 males, 113 women, mean age 50.8 +/- 16.2) agreed to participate (rate 64.3%). Prevalence of IBS was 19.1 % (19.4% for females and 18.7 % for males). IBS was associated with older age (1.05, 1.02-1.08, p <0.001) and past history of digestive diseases (5.0, 2.0-12.7, p<0.01). IBS subjects eat significantly more frequently canned food (23.74, 3.17-177.7, p<0.01), processed meat (4.7, 1.6-14.1, p<0.01), pulses (legumes) (4.0, 1.3-16.3, p<0.01), whole cereals (8.7, 2.0-37.8, p<0.01), confectionary (5.7, 1.8-23.2, p<0.01), fruit compotes (canned or not) (7.4, 2.5-23.1, p<0.001) and herb teas (4.0, 1.3-16.3, p<0.001). CONCLUSIONS: This study updates prevalence data and reveals a possible association between diet and irritable bowel syndrome.

Endoscopic clips -- what are they good for?

Several methods have been developed for the treatment of upper gastrointestinal bleedings, a condition associated with high mortality rates. In recent years new studies have been published reporting the use of endoscopic clips mainly for digestive bleeding. Our paper reviews recent publications, focusing mainly on present indications, such as: digestive bleeding, conservative treatment of perforations of the digestive tract, repair of anastomotic leaks, marking of digestive tumours, endoprosthestesis anchoring and assisting papilla cannulation.